The Health Plan of West Virginia, Inc.
Wheeling, WV 26003, USA
The Nurse Navigator is responsible for the navigation advocacy of those identified members normally on a short term, episodic or situational basis, who required coordinated care efforts as identified by various sources. These members require coordinated care and integration through review of all services requiring pre-authorization including all new technology. This may include navigation beyond the specific case or situation, providing the member with a wide spectrum of services directed at not only behavioral changes but healthy lifestyles and optimal outcomes assuring quality and continuity within the managed care system. The Nurse Navigator is responsible to conduct systemic admissions, concurrent and retrospective hospital reviews for severity of illness and length of stay, implements discharge planning and to maintain system census with required data and pertinent clinical information and appropriate interventions. Job Type: Full-time Experience: Nursing: 5 years (Required)...
